Stephanie Kim, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1800 Nations Dr Ste 211
Gurnee, IL 60031-9173

Phone

(224) 424-4194

NPI assigned

Mar 25, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mindful Support PLLC

  • Mental Health Counselor
  • Palatine, IL
  • NPI 1003689217

  IL

  Medicare reassignment NPD
• The McKnight Group LLC

  • Professional Counselor
  • Libertyville, IL
  • NPI 1447778972
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1396547154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4406 EUCLID AVE APT 2C",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600081944",
            "telephone_number": "773-963-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NATIONS DR STE 211",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319173",
            "telephone_number": "224-424-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "STEPHANIE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanober Khan, OD
• Shahreq Ali Khan, BACHELOR OF SCIENCE
• Rakhi Khanna, D.O
• Rebecca Elizabeth Kholodovsky
• Tina Khoury, DMD
• Patricia K Kimbel, PSY.D.
• Teericka Kimbrough, LCSW
• Kindred Life Ministries Inc
• Everett P Kirch, MD
• Rene Louise Kirklin

• All providers in Gurnee, IL
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.